Relationship between hypertensive retinopathy and left ventricular diastolic function and geometry among hypertensive patients in a Nigerian Tertiary Hospital
AA Onua, CE Nwafor, AC Mankwe
Background: Hypertensive retinopathy is recognized target organ damage among the poorly controlled hypertensives. Often than not, these patients simultaneously develop cardiovascular, cerebrovascular and renal complications preceded by the occurrence of subclinical left ventricular hypertrophy (LVH). Aim: To determine the relationship between hypertensive retinopathy and left ventricular diastolic function and geometry among hypertensive patients attending University of Port Harcourt Teaching Hospital. Materials and Methods: A longitudinal observational study of 175 consecutive hypertensive patients who were referred from the Cardiology unit to the Ophthalmology Department for ocular evaluation. Ophthalmological examinations were performed, which included ocular fundus assessment with direct ophthalmoscopy. Hypertension was classified according to the European Society of Hypertension/European Society of Cardiology guidelines. Two- Dimensional and Doppler echocardiographic examinations of the left ventricle were performed using ALOKA 2 Dimensional/Doppler and Color flow ultrasound machine, equipped with a 3.2 MHz transducer. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0 Results: One hundred and seventy-five patients were studied. Various degrees of hypertensive retinopathy and Left ventricular diastolic dysfunction depended on the duration of hypertension. The differences in the duration of hypertension and the abnormal fundoscopic findings was statistically significant (p=0.012).The differences in the duration of hypertension and the abnormal LV diastolic dysfunction was statistically significant (p=0.018). Conclusion:There was a positive linear relationship between hypertensive retinopathy and Left ventricular diastolic dysfunction. Dilated fundoscopy could be used as a gold standard in the evaluation of left ventricular dysfunction among the hypertensives especially in a poor-resource setting.